Referring MDs offer constructive criticism of imaging reports

A study of a system of peer review for radiology reports that included structured feedback from referring physicians was able to identify issues that may have gone unnoticed by a peer review among radiologists only, according to the results published in the October issue of the American Journal of Roentgenology.

While most of the reports were judged to be clinically useful by the referring physicians, issues related to language, typos and direct communication of results were raised by the feedback comments.

“Although the detection and interpretation of abnormalities clearly fall within the purview of the radiologist, correct reporting is a multifaceted process that not only encompasses documentation of the abnormality but, in many cases, placing the abnormality within the clinical context in which it was found, thereby aiding the referring physician in future management of the patient,” wrote Andrew J. Gunn, MD, Massachusetts General Hospital, Boston, and colleagues.

The study recruited five referring physicians to participate as reviewers. They looked at a total of 48 reports that included abdominal CT, chest CT, brain MRI and abdominal ultrasound studies.

On average, the reports were judged to be clinically useful and allow for confident clinical decision making by the referring physicians. More than one-third of the reports included recommendations for further diagnosis, and 84.7 percent of these recommendations were considered clinically appropriate by the participating physicians.

The most common complaints were unclear language and typographical errors, according to Gunn and colleagues. One comment from a referring physician indicated a lack of confidence in a report that contains grammatical or spelling errors.

Referring physicians also seemed eager in some cases to have results communicated to them directly, with 31.2 percent of reports flagged as worthy of a call. “Radiology reporting requires the radiologist to consider the radiographic findings, clinical data, and the needs and preferences of the referring physician when constructing a report,” wrote the authors.

They added that a system of structured feedback from referring providers could not only improve reporting, but also improve overall communication and camaraderie between radiologists and referring physicians.